GAVIN MCMULLEN (NPI# 1720549504) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720549504 |
| Entity Type | Individual |
| Full Name | GAVIN MCMULLEN |
| Credential | CRNA |
| Practice Address |
2101 N Waterman Ave San Bernardino CA 92404-4836 |
| Mailing Address |
29585 Chandler Rd Highland CA 92346-5415 |
| Practice Telephone | 9098838711 |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2019-03-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 125600 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2101 N WATERMAN AVE |
| City | SAN BERNARDINO |
| State | CA |
| Zip Code | 92404-4836 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992797153 | Young A Suk | Anesthesiology | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2005-08-15 |
| 1467077016 | Melissa Magdangal | Occupational Therapist | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2020-06-10 |
| 1902433303 | Ariel Chen | Physician Assistant | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2020-03-25 |
| 1417581059 | Western Acute Care Surgeons Inc | Surgery | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2020-02-22 |
| 1538704234 | Michelle Dela Cruz Villanueva | Occupational Therapist | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2019-11-17 |
| 1750943668 | Benjamin Arthur Rinard | Physician Assistant | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2019-07-01 |
| 1679132955 | Louis Gallo | Physician Assistant | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2019-06-10 |
| 1154984706 | Antonio Moreno | Anesthesiology | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2019-04-18 |
| 1003378944 | Miranda G Ideal | Nurse Anesthetist, Certified Registered | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2019-04-01 |
| 1225599780 | Kylie Brenna Leeper | Dietitian, Registered | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2019-03-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740849363 | Danniella Alexandra Murillo | Physician Assistant | 2101 North Waterman Ave, San Bernardino, CA 92404 | 2019-06-07 |
| 1902377484 | Shauntel Renee Nelson | Student in an Organized Health Care Education/Training Program | 1481 N. Windsor Dr., San Bernardino, CA 92404 | 2018-12-10 |
| 1487123584 | Garrett M Grigg | Licensed Psychiatric Technician | 1481 N Windsor Dr, San Bernardino, CA 92404 | 2018-11-19 |
| 1881163434 | James Dean Anders | Counselor | 1481 Windsor Drive, San Bernardino, CA 92404 | 2018-11-13 |
| 1043703564 | Samantha Makpaiboonvatana | Optometrist | 1909 N Waterman Ave Ste 3, San Bernardino, CA 92404 | 2018-06-09 |
| 1861981623 | Christopher Windham | Behavior Technician | 2460 Fremontia Dr, San Bernardino, CA 92404 | 2018-05-08 |
| 1891145041 | Cynthia Lusy Gastelum | Marriage & Family Therapist | 1885 E Lynwood Dr Rm Se3, San Bernardino, CA 92404 | 2016-06-20 |
| 1336598259 | Foundation Enterprises LLC | Non-emergency Medical Transport (VAN) | 1663 Date Pl., #30390, San Bernardino, CA 92404 | 2016-06-10 |
| 1881042877 | Helen Ann Thompson | Speech-Language Pathologist | 1311 E. State St., San Bernardo, CA 92404 | 2016-05-31 |
| 1366839938 | Lanecia Richardson | Counselor | 135 Paul Drive, San Rafeal, CA 92404 | 2015-04-22 |
| Find all providers in zip 92404 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003378944 | Miranda G Ideal | Nurse Anesthetist, Certified Registered | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2019-04-01 |
| 1568934818 | Andrew Steven Lim | Nurse Anesthetist, Certified Registered | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2018-12-27 |
| 1285128694 | Christina Maria Picar Canio | Nurse Anesthetist, Certified Registered | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2018-06-19 |
| 1083128839 | Southland Anesthesia Consultants Inc | Nurse Anesthetist, Certified Registered | 1805 Medical Center Dr, San Bernardino, CA 92411-1217 | 2017-11-30 |
| 1699866459 | Louise Harrell | Nurse Anesthetist, Certified Registered | 165 W Hospitality Ln, Suite 1, San Bernardino, CA 92408-3334 | 2006-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720687395 | Anesthesia First, Inc | Nurse Anesthetist, Certified Registered | 1332 W Herndon Ave Ste 102, Fresno, CA 93711-7118 | 2020-10-23 |
| 1659970580 | Twilight Nursing Anesthesia Services Inc | Nurse Anesthetist, Certified Registered | 1247 W Bloomwood Rd, Rancho Palos Verdes, CA 90275-1937 | 2020-10-21 |
| 1881201432 | Edc Anesthesia Nursing PC | Nurse Anesthetist, Certified Registered | 72301 Country Club Drive, Suite 101, Rancho Mirage, CA 92270-8007 | 2020-09-28 |
| 1720697501 | Elizabeth Diane Doty | Nurse Anesthetist, Certified Registered | 235 N Conejo School Rd Apt 116, Thousand Oaks, CA 91362-2676 | 2020-07-28 |
| 1447868013 | Matthew Shirts | Nurse Anesthetist, Certified Registered | 6713 E Princeton Ave, Fresno, CA 93727-1441 | 2020-07-20 |
| 1730797705 | Ryan James Tobin | Nurse Anesthetist, Certified Registered | 1786 El Paso Ave, Clovis, CA 93611-6601 | 2020-07-16 |
| 1922626167 | Ileana Lopez | Nurse Anesthetist, Certified Registered | 388 E Ocean Blvd Unit 702, Long Beach, CA 90802-5264 | 2020-07-13 |
| 1154946085 | Brianna Koty | Nurse Anesthetist, Certified Registered | 1611 Greenwood Ave, Torrance, CA 90503-6134 | 2020-06-16 |
| 1962025973 | Franesei Crna A Nursing Corporation Inc | Nurse Anesthetist, Certified Registered | 2601 W Alameda Ave Ste 312, Burbank, CA 91505-4812 | 2020-05-26 |
| 1144858028 | Dennis Casanova Colon | Nurse Anesthetist, Certified Registered | 547 E Weldon Ave, Fresno, CA 93704-6031 | 2020-03-27 |
| Find all providers with the same taxonomy | ||||
| City | SAN BERNARDINO |
| Zip Code | 92404 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.